ABSTRACT Hyperthyroidism is a common endocrine disorder characterized by excess circulating thyroid hormones, resulting in multisystem involvement and increased morbidity if inadequately treated. Thyroxine and triiodothyronine play a main role in regulating metabolism, growth, and organ function, and dysregulation of their secretion leads to thyrotoxicosis. Hyperthyroidism may be classified as overt or subclinical based on the biochemical findings. The global prevalence of hyperthyroidism ranges from 0.2% to 1.3%, with Indian studies reporting a prevalence of approximately 0.9%–1.5% in community-based populations. This review summarizes the etiopathogenesis, clinical presentation, diagnostic evaluation, and management of hyperthyroidism, with particular emphasis on evidence from India. Graves’ disease is the most common etiology in iodine-sufficient regions, followed by toxic multinodular goiter, toxic adenoma, and thyroiditis. Diagnostic approaches including biochemical testing, thyroid-stimulating hormone receptor antibody assays, thyroid ultrasonography with Doppler, and radionuclide imaging are discussed to facilitate accurate etiological differentiation. Management strategies encompassing symptomatic therapy, antithyroid drugs, radioactive iodine therapy, and surgery are reviewed. The principles of antithyroid drug dosing, titration, duration of therapy, monitoring, treatment-related adverse events, and predictors of remission and relapse are outlined. The review also discusses management considerations in special clinical situations, including acute thyroiditis, thyroid storm, and in women of child-bearing potential, during pregnancy, and lactation. Early recognition and individualized, etiology-based management are essential to prevent complications such as atrial fibrillation, osteoporosis, heart failure, and adverse pregnancy outcomes.
Joshi et al. (Thu,) studied this question.